The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects.

  • Edward Lawrence Keyes
Date:
1889
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Licence: Public Domain Mark

Credit: The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    lymphatics along the dorsum or side of the penis. In chordcc, great pain is felt from the stretching of the inflamed erectile tissue. This pain is measurably relieved hy bending the penis so as to increase the bow, and in this way to slacken the string; and it passes off entirely as erection disappears. Chordee is most frequent during the night and toward morning. It may render sleep impossible. The point of great- est curvature is situated anywhere along the pendulous urethra, most frequently near the glans—gland arque (Ricord). The pernicious practice of breaking the chordee, which consists in roughly straight- ening the penis when erect, gives rise to a haemorrhage which may become excessive and be the starting-point of organic stricture. After the disease has continued at its height for from one to three weeks under favorable circumstances, the pain on urination, which had traveled down to the root of the penis, ceases, the discharge be- comes more watery, chordee infrequent. The discharge diminishes down to a drop in the morning, the meatus again sticks together, and finally even this ceases, and the patient is well. During all this local inflammatory disturbance there is little if any constitutional sympathy. There may be some feverishness for a time, or, in nervous individuals, a real or fancied feeling of prostration during the continuance of the discharge. The DuRATio]!«r oe Go]sroRRH(EA is variable. A well-managed case lasts from three to six weeks, as a rule ; but the discharge may con- tinue for months or even years. A first gonorrhoea is the most se- vere ; but it is also the most certain to get perfectly well if carefully managed. Course of Gokorrhcea.—The urethral inflammation commences at the meatus and travels slowly backward. According to Desor- meaux,* on the eighth day of the discharge, the anterior half of the urethra has become invaded, its surface is congested, without polish, and covered with little bare spots, like those seen in balanitis, where the epithelium has exfoliated. There is no ulceration. When the discharge is older, the lesions are identical, but deeper seated. The disease tends to limit itself and to become localized at the bulb, in the fossa navicular!s, or at some intermediate point, where there may have been much chordee; At these points of localization, the surface is of a vinous red, the polish of healthy epithelium is absent, and there are perhaps a few granulations. The submucous tissue thickens, impair- ing the vascularization of the part, and this process may go on to the formation of organic stricture. Where the disease runs this course, instead of getting well, we have gleet. Gleet.—In gleet, whether due to forming stricture or not (the former condition is vastly more common), a certain amount of sticky, * De I'Endoscope et de ses Applications au Diagnostic et au Traiteaient des Affec- tions de rUrethre et de la Vessie, Paris, 1S65.
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